Repositório RCAAP

The text presents results of theological research on aspects of the situation generated by the effects of the pandemic caused by COVID-19 in Brazil and worldwide. Methodologically, the analysis was structured in three moments that describe, in summary, the results of the research. The first indicates the reflexes of the pandemic within the context of necropolitics that intensify the implications of the pandemic for the poorest and most vulnerable sectors of society. The second shows how religious experiences enhance the simultaneous presence of obscurantist forms and others that, on the contrary, are characterized by dialogue with the sciences and by the maturity of social responsibility. The third moment is related to aspects of human fragility and the delicate tasks of facing them, with the possibility of spontaneous, creative and plural forms of spirituality that favor perspectives of hope. The fourth, briefly describes the understanding about the expressions of spirituality in relation to aspects that mark alterity in the context of the pandemic.

This work is divided into three parts. In the first, a historical-philosophical study on the medieval concept of “book of nature” is presented, relating this topic to analogical and religious hermeneutics developed by key authors such as Saint Augustine, Saint Isidore of Seville and Hugh of Saint Victor. To find the root of this allegorical-symbolic view of the natural world, older sources of Greco-Roman and Patristic culture are identified. In the second part, we study the presence and scope of naturalistic analogies in the Sermons of Saint Anthony of Lisbon. He who can very well be considered one of the most accomplished medieval cultists of this interpretative method, bringing to the text what for his Franciscan brothers was a daily experience. Few as Doctor Evangelicus knew how to match the symbolism of nature in such a fruitful and skilful way with theological reflection. In the third part, we examine the prevalence of the same concept in Father António Vieira's Sermonary. Baroque man and already deeply marked by the scientific revolution underway in his time, which will lead to the emancipation of the study of nature and the break with the theological discourse, the Jesuit preacher still maintains a foot well established in medieval tradition and in naturalistic analogical thought, in a final attempt to reconcile science and religious belief.

This article is intended to bring faith, hope, and charity as forces of life and resurrection in a pandemic world. The Covid-19 pandemic brought us challenges and new situations that deserve to be addressed and dealt with specifically. This situation brings us new questions for our society, for humanity and these new questions also challenge us theologically. Therefore, we aim to offer a reflection that points out horizons and brings theological and practical implications. Methodologically, we will continue with the speeches of Pope Francis, who draws attention to the gravity of this moment and insists that this is a favorable time to rethink our way of life and our relationships. We will follow the approach of theologians who help us to understand this problem and in a dialectical way, we will bring the questions that challenge us in this context. The work is divided into three parts: first, the questions that come to us from this pandemic world. In the sequence, we will make a theological development on faith, hope, and charity, updating and bringing reflection to our context. Finally, we will approach the theme of the resurrection, as a proposal for life and the possibility of transformation.

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In the present paper we will explore the different levels of deregulation and expression of suffering induced by a somatic illness or by a disease in individual subjectivity. These levels are part of a singular functional and organizational structure of the self and personality.

The use of auxiliary diagnostic means in psychiatry is an old problematic issue, mainly because the nature of the process of becoming mentally ill, together with the conceptual approach that has being used to explain it. The recent technological advances, mainly in the neuroimage techniques, have come to increase the hope of using the knowledge acquired by those studies in the psychiatric clinical practice. However, that hope vanished quickly. In this paper, the author analyzes the putative reasons to explain that failure, proposing at the same time the reasons and the evidence that sustain the clinical use of another technology – the quantitative electroencephalography (qEEG) – using several clinical cases to illustrate the use of qEEG in different clinical situations.

The scope of psychopathology as a discipline, its method and targets are important to understand mental disorder as well as define what is to be assessed in the mental state examination. For more than a century the request of objectivity and reliability for research, strict insurance policies and the increase of clinical workload have enforced categorization and operationalization of psychopathological phenomena. This move was blamed to have led psychopathology into a dead end, undermining present research and clinical diagnosis. By revisiting the some of the missteps of xxI century psychopathology we find assorted phenomenological and ontological predicates that might have contributed to such damage. They include changes in the nature of the approach necessary to access and collect psychopathological phenomena as well as a reductionism in the dimension of meaning that is relevant for psychopathology. This essay suggests that the foundational stones of the Person-centred Approach (PCA) are a relevant training by addressing most the previous qualms. It is our belief that psychopathologists trained in PCA could improve their relational framework and acquire the ontological precepts to correctly access and assess a wider range of mental phenomena.

Background: Patients with schizophrenia often present sleep complaints which have been related to poor patient quality of life. Physiologic sleep, compatible with work routines is necessary, and may translate into better social functioning, engagement in rehabilitation strategies, and satisfaction with life. Methods: In this cross-sectional, non-interventional study, 811 adult outpatients with a diagnosis of schizophrenia were divided into two groups according to the presence (or absence) of sleep disturbances, and assessed using measures of symptom severity, quality and patterns of sleep (Pittsburgh Sleep Quality Index - PSQI), personal and social functioning, and satisfaction with life. Results: Patients with sleep disturbances were significantly more symptomatic, and revealed worse quality of sleep on all componentes of the PSQI (p

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Abstract: Background: There is insufficient evidence regarding the impact of compulsory outpatient treatment (COT). Aims: We evaluated the impact of COT over one year on symptoms, personal and social functioning, insight and cognition. Methods: Naturalistic, longitudinal analysis, at baseline and one-year follow-up, of 15 patients followed in a specialized COT clinic. Patients underwent a standardized evaluation with the Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), Berrios-Markova insight scale and Scale to Assess Unawareness in Mental Disorder (SUMD), Trails A and B, Digit Span, and the Controlled Oral Word Association Test (COWA). Results: At follow-up there was significant improvement in personal and social functioning (baseline total PSP: mean=46.9; follow-up: mean=59.3), and specifically in socially useful activities including work and study (p=0.012), and personal and social relationships (p=0.033). Three patients (20%) scored =>69 on the PSP, a good level of functioning. However, we found no significant improvements in symptoms (PANSS=56.8), subjective or objective insight (Berrios- Markova=10.0 and SUMD=11.0), or cognitive performance. Conclusions: At one-year follow-up, patients on COT showed significant improvement in personal and social functioning, specifically in socially useful activities including work and study and in personal and social relationships, but no improvement in symptoms, insight and cognitive functioning.

Abstract: Objective: to conduct a systematic review of the literature regarding the impact of family psychoeducation on the treatment of bipolar disorder. Methodology: PubMed, Lilacs, Web of A search was conducted in Science, Science Direct and Scopus using the descriptors: family psychoeducation and bipolar disorder. The last 13 years were considered. Results: 542 articles were found and after considering inclusion and exclusion criteria, 29 were selected for the study. Three other articles nominated by specialist were also used. Overall, patients diagnosed with bipolar disorder should be treated with drug therapy combined with psychotherapy. Most studies showed that the conventional treatment associated with psychoeducation reduced relapse rates and hospitalizations and that long-term programs generated better results. A comparison between supportive psychotherapy and family psychotherapy showed that it was only effective in patients who received the latter. Conclusion: although the role of pharmacological treatment is well established for the patient, (OU “ESTABLISHED IN LITERATURE”?) almost all articles consulted claim that if family psychoeducation is associated with medication, it can help with the early detection of warning signs of a crisis, reduce hospitalization rates and help reduce the number of drugs taken.

Abstract: The incidence of brain tumours has increased in recent years. They represent the second most common cause of death attributable to neurological conditions. Although expansive brain lesions often lead to observation by Neurology or Neurosurgery, it is not uncommon for psychiatric symptoms to be the reason for initial contact with medical care. Brain tumours may present as symptomatology similar to the so-called primary, or functional, psychiatric disorders. However, in contrast to psychiatric disease in other types of cancer, where adjustment disorders predominate, organic syndromes are the most frequent diagnosis in patients with CNS tumours. Anatomic location represents one of several factors that contribute to the nature and severity of psychiatric conditions. Tumours of the frontal lobe are more frequently associated with changes in executive function, amotivational syndrome and personality changes. Temporal tumours can trigger psychotic symptoms such as hallucinations and delusions. The treatment of the symptomatology will essentially involve removal of the lesion whenever possible. Nevertheless, symptomatic treatment of psychiatric manifestations should always take place. Psychopharmacology, psychotherapy and psychoeducation of caregivers are the best modes of treatment.

Abstract: Introduction: Evaluating adherence to treatment with antipsychotic agents in patients with schizophrenia is a challenge for any psychiatric doctor, given its inherent subjectivity. Despite this, nonadherence to treatment is prejudicial to the clinical course of the disease, resulting in a greater risk of acute exacerbations of illness and hospital admissions. The aim of this study is to review the current literature on factors that influence adherence to antipsychotic treatment in patients with schizophrenia. Methods: The literature, written in English between 2006 and 2016 and available in full in PubMed/MEDLINE, evaluating potential risk factors for treatment compliance in adult patients (over 18 years of age) with schizophrenia, was reviewed by searching on the keywords: adherence, nonadherence, compliance, noncompliance, schizophrenia, psychosis, antipsychotic, neuroleptic. Results: Thirty-nine studies were included in the final review. The average level of treatment adherence was 32%. The following risk factors for nonadherence to treatment were identified: young age, substance abuse, psychotic psychopathology present, absence of insight into the disorder and the need for treatment, negative attitudes to treatment, poor doctor-patient relationship and lack of social and family support. Conclusions: Interventions aimed at improving treatment adherence must be individualised for each patient, on the basis of a full clinical history, so that all the individual aspects contributing to this variable can be appropriately assessed.

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Introduction: Muscular dysmorphia (DM) is a subtype of body dysmorphic disorder, which occurs in individuals who, despite having a muscularly developed physique, consider themselves thin and weak. Currently, it is assumed that the use of androgen‑anabolic steroids (AAS) may be a perpetuating factor in this disorder, but also that DM may predispose to the use of AAS, drugs frequently used for their effects on body composition, namely the increase in muscle mass body composition, but with vast side effects. This systematic review aimed to explore the current evidence about the association between DM and the use of AAS. Methods: Systematic review of recent literature, including articles published between June 2009 and January 2019. Results: Twelve articles were included, with the majority of studies establishing an association between these two variables, the results oscillating between the absence of statistically significant differences and a strong association, the latter being the most frequently found. Conclusion: The existing evidence of the association between DM and the use of AAS is still not very consistent, which may be due to the heterogeneity of the tools used to compare the same variables. Thus, it is important to establish an optimal model for collecting more sensitive information, and to establish better validated DM assessment scales, so that data collection and analysis can be as accurate as possible.

Shiftwork is a key characteristic of the working environment of the XXI century. We can define this type of work schedule as any work that takes place outside the usual working hours with the goal of providing a continuity of services. Healthcare constitutes a sector where shiftwork is particularly necessary. The aim of this study is to review the current literature on the influence of shiftwork in the development of sleep and mental disturbances. The literature found on PubMed/MEDLINE from 1984 to 2017, with full text available written in English that assessed the effects of shiftwork on mental health and sleep was reviewed by searching on the keywords: shiftwork, mental health, sleep disorders, circadian rhythm. This study found that shiftwork produces important effects regarding sleep and mental health. Concerning sleep, this type of work increases excessive somnolence and insomnia. As to mental health, depression, suicide ideation, cognitive impairment and substance abuse are greatly influenced by shiftwork. Shiftwork has a significative impact in workers’ mental health, cognitive function and sleep patterns. Considering this, it is crucial to know how to identify this toll to adopt the necessary measures to minimize the effects of shiftwork on workers’ health, especially in those who are most vulnerable, as it happens in the healthcare system.

Marchiafava‑Bignami disease is a rare condition associated with chronic alcohol consumption and/or malnutrition, characterized by demyelination of the corpus callosum, generally attributed to a deficiency in B complex vitamins. We report the case of a 34‑year‑old male with a 10‑year history of alcohol dependence who was admitted to the hospital, after having been found lying on the floor of his house, malnourished and with pressure ulcers on his chest and knees. On clinical observation he was found to be alert but mute. He followed some simple orders. Generalized spastic hypertonia was present. Magnetic resonance imaging showed demyelination of the corpus callosum, suggesting the diagnosis of Marchiafava‑Bignami disease. He was admitted to the Psychiatry Inpatient Unit and evaluated by a multidisciplinary team. He received thiamine, corticosteroids and rehabilitation. After a week, his speech was slurred but comprehensible and he could walk with aid; magnetic resonance imaging findings had improved. After three months in a Convalescence Unit, he was discharged with total autonomy.

Delusional parasitosis, also known as delusional infestation or Ekbom syndrome, is a somatic type of delusional disorder, usually mono‑symptomatic, in which patients are convinced they are being infested with animal parasites while no objective evidence to support their belief exists. Complaints are usually about skin infestation, but involvement of the gastrointestinal tract has also been described. We describe a case of a 59‑year‑old woman with delusional parasitosis claiming to be infected with Strongyloides stercoralis.

Evidence has been suggesting that neurochemical and behavioral adaptations emerging during one addictive behavior may enable a subsequent, different, addiction, even when the first one has ended. Such association seems remarkably accurate to fat bingeing and ethanol consumption, which constitute a relevant example of addictive patterns sequential association, particularly in adolescence. Therefore, the main purpose of the following review is to comprehend if adolescents who have engaged on fat bingeing escalated their ethanol consumption, after fat bingeing terminus, and secondly, in a positive scenario, to highlight why such association may happen. After searching databases such as MEDLINE (PubMed) and Clarivate Analytics Web of Science, all articles focused on adolescent humans or adolescent rats or adolescent mice, that included topics on fat bingeing and consequent ethanol consumption, were considered. Gathered results strengthened the referred hypothesis. Reports stating that adolescent fat bingers engage on escalated ethanol consumption were fundamentally supported by a prevalent fast food and ethanol cultures, bingers ‘shared personality traits, adolescence ‘susceptibilities for addictive behaviors and neurochemical and behavioral craving installment after fat bingeing cessation. Given that adolescence is a key structural and functional phase of human development, and that fat and ethanol consumption are linked to harmful physiological and social effects, priority must be given to multidisciplinary interventions aiming to challenge addictions, both pharmacologically and psychotherapeutically.

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